NPIMap

Lisa Rachel Koslow, M.D.

Individual provider Active NPI Pediatrics Physician · Old Bethpage, NY

NPI 1407919772 · NPPES record last updated Aug 22, 2013

Key facts

NPI
1407919772
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
235268 (NY)
Practice address
700 Old Bethpage Rd
Old Bethpage, NY 11804-1240
Phone
(516) 293-0666
Fax
(516) 293-8218
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
235268NYMDPediatrics Physician

Practice roles (1 of 5)

OrganizationSpecialtyStatusNew patients
Allied Physicians Group, PLLC Pediatrics Past Accepting new patients

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: lisa.koslow.1@29151.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 235268 NY Yes

Addresses

Primary practice location

700 Old Bethpage Rd
Old Bethpage, NY 11804-1240

Mailing address

700 Old Bethpage Rd
Old Bethpage, NY 11804-1240
Phone (516) 293-0666

Other providers in Old Bethpage, NY

All providers in Old Bethpage, NY · Pediatrics Physician in New York

Sources for this page

Verify at the official NPI Registry.